# CENTER CREEK COUNSELING

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1639581150
- **Authorized official:** CHASTITY ANN INGRAM (OWNER/PROVIDER)
- **Authorized official phone:** (308) 470-1338

## Contact information

- **Practice address:** 775 31 RD, FRANKLIN, NE 68939-5158
- **Practice address phone:** (308) 470-1338
- **Practice address fax:** (308) 425-3167
- **Mailing address:** 775 31 RD, FRANKLIN, NE 68939-5158
- **Mailing address phone:** (308) 470-1338
- **Mailing address fax:** (308) 425-3167

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1041C0700X | Clinical Social Worker | 1342 | NE | Yes |

## Other

- **Enumeration date:** 06/02/2014
- **Last updated:** 10/12/2015

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 10025916400 | — | NE |
| 05 | — | 10025916700 | — | NE |
| 05 | — | 200433160F | — | KS |
| 01 | — | NA1760 | MEDICARE PTAN | — |